AS A PROSPECTIVE client searches for a psychotherapist, numerous questions may spring to mind. How experienced is the therapist? Has he helped people with problems like mine? Is she someone I can relate to? Yet it may not occur to clients to ask another one: What type of therapy does the clinician deliver? People often assume that the brand of therapy offered is irrelevant to the effectiveness of treatment. Is this assumption correct?
Psychologists do not agree on whether the “school” of therapy predicts its effectiveness. In a survey in 2006 by psychologists Charles Boisvert of Rhode Island College and David Faust of the University of Rhode Island, psychotherapy researchers responded to the statement that “in general, therapies achieve similar outcomes” with an average score of 6 on a 7-point scale, indicating strong agreement. In contrast, psychologists in practice averaged a rating of 4.5, signifying that they agreed only moderately with that position.
As we will discover, both camps can justify their point of view. Although a number of commonly used psychotherapies are broadly comparable in their effects, some options are less well suited to certain conditions, and a few may even be harmful. In addition, the differences among therapies in their effectiveness may depend partly on the kinds of psychological problems that clients are experiencing.
Tale of the Dodo Bird
At least 500 different types of psychotherapy exist, according to one estimate by University of Scranton psychologist John Norcross. Given that researchers cannot investigate all of them, they have generally concentrated on the most frequently used approaches. These include behavior therapy (altering unhealthy behaviors), cognitive-behavior therapy (altering maladaptive ways of thinking), psychodynamic therapy (resolving unconscious conflicts and adverse childhood experiences), interpersonal therapy (remedying unhealthy ways of interacting with others), and person-centered therapy (helping clients to find their own solutions to life problems).
As early as 1936, Washington University psychologist Saul Rosenzweig concluded after perusing the literature that one therapy works about as well as any other. At the time, many of the principal treatments fell roughly into the psychodynamic and behavioral categories, which are still widely used today. Rosenzweig introduced the metaphor of the Dodo Bird, after the feathered creature in Lewis Carroll’s Alice in Wonderland, who declared following a race that “everyone has won, and all must have prizes.” The “Dodo Bird verdict” has since come to refer to the claim that all therapies are equivalent in their effects.
This verdict gained traction in 1975, when University of Pennsylvania psychologist Lester Luborsky and his colleagues published a review of relevant research suggesting that all therapies work equally well. It gathered more momentum in 1997, when University of Wisconsin–Madison psychologist Bruce E. Wampold and his co-authors published a meta-analysis (quantitative review) of more than 200 scientific studies in which “bona fide” therapies were compared with no treatment. By bona fide, they meant treatments delivered by trained therapists, based on sound psychological principles and described in publications. Wampold’s team found the differences in the treatments’ effectiveness to be minimal (and they were all better than no treatment).
One explanation for the Dodo Bird effect is that virtually all types of psychotherapy share certain core features. In a classic 1961 book the late psychiatrist Jerome Frank of the Johns Hopkins University argued that all effective therapies consist of clearly prescribed roles for healer and client. They present clients with a plausible theoretical rationale and provide them with specific therapeutic rituals, he wrote. They also take place in a setting, usually a comfortable office, associated with the alleviation of distress. Later writers elaborated on Frank’s thinking, contending that effective therapies require empathy on the part of the clinician, close rapport between practitioner and client, and shared therapeutic goals.
Today many authors argue that these and other common elements are even more powerful than the features that distinguish one therapy from another. To take just one example, Wampold concluded in a 2001 analysis that the therapeutic alliance—the strength of the bond between a therapist and his or her client—accounts for about 7 percent of therapeutic effectiveness but that the school of the therapy accounts for only about 1 percent. Most of the remaining 92 percent is presumably caused by other factors, such as the personalities of the therapist and client.
Is the Dodo Bird Extinct?
Although most researchers agree that common factors play key roles in psychotherapy, some doubt that all methods are equally effective. Even Wampold has been careful to note that his conclusion holds for only bona fide treatments; it does not extend to all 500 or so therapies. For example, few experts would contend that rebirthing therapy, premised on the dubious idea that we must “relive” the trauma of our birth to cure neurosis, works as well as cognitive-behavior therapy for most psychological conditions.
Moreover, research suggests that even among accepted therapies, the type of treatment does matter under certain circumstances. A 2001 review by University of Pennsylvania psychologist Dianne Chambless and Virginia Polytechnic Institute psychologist Thomas Ollendick revealed that behavior therapy and cognitive-behavior therapy are more effective than many, and probably most, other treatments for anxiety disorders and for childhood and adolescent depression and behavioral problems. In addition, in a 2010 meta-analysis psychologist David Tolin of the Institute of Living in Hartford, Conn., found that these same two therapy types produce better results than psychodynamic therapy for anxiety and mood disorders.
The Dodo Bird verdict must also be qualified by evidence indicating that several widely used therapies do not work and may actually harm. For example, in a 2003 review psychologist Richard McNally of Harvard University and his colleagues evaluated crisis debriefing. In this treatment for warding off post-traumatic stress symptoms, therapists urge those exposed to emotionally fraught events such as shootings or earthquakes to try to reexperience the feelings they had during the event soon after it. McNally’s team concluded that this treatment is inert at best and possibly damaging, perhaps because it interferes with natural coping mechanisms.
In light of such findings, a search for a therapist should at least sometimes involve a consideration of the type of treatment he or she practices. It is true that ingredients, such as empathy, that cut across effective therapies are potent and that various established techniques are roughly equivalent for a broad range of difficulties. Yet under certain circumstances, the therapeutic method can matter. For example, if a clinician espouses an approach outside the scientific mainstream—one that does not fall under the broad categories we have listed here—you should not assume that this treatment will be as helpful as others. If you suffer from an anxiety disorder or one of the other conditions for which behavior and cognitive-behavior interventions work well, then someone who practices one of those two types is probably a good bet.
Of course, scientists have systematically assessed only a minority of the psychotherapies invented so far for their efficacy in treating the numerous psychological difficulties that afflict humankind. In the coming decade, we hope that further research clarifies whether the brand of therapy makes a difference in an individual’s recovery from psychological distress.
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Updated 3/7/2022
There are many different types of therapy that might be right for you. To make the choice manageable, we broke them down into the factors that make a “type” of psychotherapy (you can use the handy links below to jump around the guide):
Whether you are an aspiring therapist planning your career path or a potential client looking for the type of therapy that best fits your preferences, considering all of these factors is crucial. “Type of therapy” typically refers to a therapeutic approach, but this factor is not more important than others. Many clients and therapists value the other factors far more than the particular therapeutic approach. By the end of this article, you’ll be able to find the right kind of therapy session for your mental health condition.
In-Person or Online Therapy
Regardless of therapeutic approach, online therapy offers results that are in line with in-person therapy. Even less traditional methods of therapy, such as dance therapy and art therapy, can now be realistically administered online with new video technology platforms.
With the exception of severe mental illnesses that require intensive in-person treatment, the choice between online therapy and in-person therapy is a matter of preference.
The Most Common Types of Therapy
There are more than fifty types of therapeutic approaches. Yet, only a few of them are common. Here are the types you are most likely to encounter. These approaches apply regardless of the other type factors we will explore later in the guide.
Note: Remember, most therapists blend therapeutic approaches and customize an integrated counselling approach for each client.
Client-Centered Therapy (Person-Centered Therapy, PCT, CCT or Rogerian Therapy)
Client-centered humanistic therapy focuses as much on the client as possible. The therapist provides little authority or direction. Instead he or she offers subtle guidance on an individual’s life or mental health illness and encourages the client to take control of their future.
CCT therapists demonstrate more overt care for their client than more analytical therapists. They put more time and effort into empathizing with clients.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy, or also known as CBT treats dysfunctional thinking that leads to maladaptive behaviors, mental illness, and negative emotion. It focuses on thoughts and behaviors. This type of therapy is often used to treat individuals with Bipolar Disorder, Borderline Personality Disorder, Anxiety Disorder, and much more.
Existential Therapy (part of the Humanistic-existential Approach)
Humanistic therapy as a whole focuses on one’s personal life experience to help guide individuals in reaching their full potential. Existential therapy is part of the Humanistic-existential Approach which helps clients manage aspects of the human condition, including all the givens of human existence: isolation, meaninglessness, mortality, and freedom.
Gestalt Therapy (part of the humanistic category)
Gestalt therapy emphasizes personal responsibility and helps clients focus on the present. It also stresses the development of the therapist-client relationship, the social context of the client’s life, awareness, attitudes and direct feelings and perceptions rather than interpretations.
Psychoanalytic or Psychodynamic Therapy
The psychodynamic therapy approach explores unconscious feelings or thoughts and the impact of the past on the present. It is the oldest type of psychotherapy and closest to what Freud created.
Dialectical Behavior Therapy (DBT)
Dialectical Behavior Therapy uses a problem solving and acceptance-based framework — among other strategies — usually to treat severe and chronic mental health conditions, including: borderline personality disorder, suicidal ideation, self-harming, eating disorders and PTSD.
Less Common Types of Therapy
There are so many types of psychotherapy. To stop the information from overwhelming you, think about what you most want from psychotherapy then scroll through and see which keywords align with what you were thinking.
Note: To make the list manageable, this guide mostly focuses on talk therapy for adults and excludes forms of psychotherapy that are controversial or do not have sufficient evidence to back their effectiveness.
Accelerated Experiential Dynamic Therapy (AEDP)
AEDP explores difficult emotional and relational experiences to develop coping tools that allow better functioning.
Acceptance and Commitment Therapy (ACT)
ACT helps clients develop mindfulness skills with the goal of consistent values and psychological flexibility.
Adlerian Psychotherapy
This approach improves the ability to adapt to feelings of inadequacy and inferiority relative to others.
Anger Management
This approach teaches clients to identify stressors, remain calm and handle tense situations in a positive and constructive manner.
Bibliotherapy
This approach uses literature to improve mental health and explore psychological issues.
Coherence Therapy (Depth-Oriented Brief Therapy)
Coherence therapy helps clients empathetically and quickly delve into deeply held emotional beliefs.
Collaborative Therapy
In collaborative therapy both the therapist and client use knowledge and experience to make progress.
Compassion-Focused Therapy
This approach encourages people to be compassionate toward themselves and others.
Conflict-Resolution Therapy
This approach teaches clients how to resolve conflicts with great results and minimal stress.
Contemplative Psychotherapy
This approach integrates Buddhist teachings and Western psychotherapy to focus on self-awareness, improve overall health and use wisdom to heal.
Core Process Psychotherapy (CPP)
CPP is a mindfulness-based approach that emphasizes awareness of body and mind for self-exploration and healing.
Ego State Therapy
Based on psychodynamic therapy, ego state therapy operates under the principle that a person’s psyche is composed of identities and roles he or she takes on. It addresses these identities and the mental health issues they might be connected to.
Emotion-Focused Therapy (EFT)
Emotion-Foucsed Therapy (EFT) uses emotions as a source of healing and insight. It is especially effective for moderate depression, issues of childhood abuse and couples in the middle of a conflict.
Holistic Psychotherapy
Holistic psychotherapy integrates other therapeutic approaches and focuses on the relationship between mind, body and spirit.
Intensive Short-Term Dynamic Psychotherapy (ISTDP)
ISTDP helps clients permanently change character flaws in a short period of time by releasing emotional inhibitions and discussing the source of character issues.
Interpersonal Psychotherapy (IPT)
IPT focuses on interpersonal issues such as relationships and major life events. Its goal is to improve mood and interpersonal issues within 6-20 weeks.
Journey Therapy
In journey therapy, the therapist guides the client on a mental and emotional journey to uncover repressed memories that have created issues in the present.
Jungian Psychotherapy
Jungian psychotherapy focuses on the balance of consciousness and unconsciousness. Clients can become more whole and well-adjusted by achieving this balance and exploring both sides.
Logotherapy
Logotherapy focuses on the pursuit of meaning and purpose in one’s life.
Mindfulness-Based Cognitive Therapy
This therapy combines the best of CBT with mindfulness strategies that help clients assess thoughts in the present.
Motivation Enhancement Therapy (MET)
MET focuses on improving motivations to make positive changes and eliminate maladaptive patterns.
Narrative Therapy
Narrative therapy helps clients interpret their experiences as stories that give meaning to their lives and guide them. It encourages people to identify their skills, values, and knowledge so they can use them to live well.
Positive Psychotherapy
This approach helps clients view their illness or issues in a positive way. It focuses on the abilities of the client, inner balance, storytelling and hope.
Rational Emotive Behavior Therapy (REBT)
REBT helps clients develop rational thinking to facilitate healthy emotional behavior and expression. It is similar to CBT.
Reality Therapy
Reality therapy focuses on present issues and encourages clients to change behavior that might be preventing them from addressing those issues. It operates under the principle that people experience distress when they are not meeting five basic needs: power, love/belonging, freedom, fun and survival.
Redecision Therapy
Redecision therapy helps clients examine messages from caretakers and adults in their childhood, as well as any negative decisions.
Regression Therapy
Regression therapy addresses three layers of consciousness and helps clients align them.
Relational Psychotherapy
Relational psychotherapy helps clients become cognitively and emotionally healthy by forming and maintaining fulfilling relationships.
Schema Therapy
Schema therapy helps clients identify the cognitive and behavior patterns that are causing or maintaining their mental health issues. It is especially effective in treating borderline personality disorder.
Solution-Focused Brief Therapy (SFBT)
SFBT focuses on goals for the present and future rather than addressing the past or symptoms.
Symbolic Modeling
This therapeutic approach uses symbols, progressive questioning, metaphors and modeling to enact positive change.
Integrated or Singular Therapeutic Approach
Most psychotherapists use an integrated approach that combines various aspects of the aforementioned therapeutic approaches. They then customize the approach based on the client’s needs and preferences.
An integrated approach is usually as effective as a singular therapeutic approach. There are, however, circumstances where clients might prefer or benefit more from a singular approach.
It usually depends on whether the client is coming to therapy for a specific issue. If a client has borderline personality disorder, a singular DBT approach might work better than an integrated approach. For general mental health issues or depression and anxiety, an integrated approach could be more effective.
Clients who like a more rigid structure of treatment should choose a singular approach. On the other hand, an integrated approach is better for clients who see therapy as a place to explore issues without limit.
Types of Therapy for Groups (Couples, Families or Group Therapy)
Therapists can apply aspects of the aforementioned therapeutic approaches to individuals, couples, and groups.
While couples therapy applies to two or more people working on the health of their relationship, clients can use individual or group therapy to work on their self–identified personal challenges. Individual therapy provides singular attention and yields results that apply to that individual. Group therapy may take more time but can also be a more affordable option. People also might like the opportunity to connect with others who have similar issues or experiences.
Couples Therapy
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Collaborative
Couple Therapy
[CCT]: couples learn to help each other with problems rather than opposing each other
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Developmental Model of Couples Therapy: focusing on partners’ development individually and as a couple
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Gottman Method Couples Therapy: a structured and goal-oriented form of therapy that focuses on understanding, empathy, connectedness, disarming verbal conflicts and fostering interpersonal growth
- Imago Relationship Therapy: using spiritual, behavioral and Western psychological methodologies to help couples relate to each other in healthy ways, resolve conflicts and explore childhood factors that might have lead to current issues
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Relational Life Therapy: helping partners resolve conflicts, develop personal accountability, improve communication and foster intimacy
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Relationship Enhancement Therapy: teaching couples and families to better communicate feelings and develop coping strategies
Family Therapy
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Family Attachment Narrative Therapy:
family therapy
for behaviorally disturbed children, often children who suffered from abuse and attachment issues in the past
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Family Systems Therapy: uses systems theory as a foundation to explore how behaviors influence the
functioning of a family
unit and vice versa, usually tackles family conflicts
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Filial Therapy: teaching parents play therapy techniques so they can use the techniques with their children
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Internal Family Systems: fully understanding individuals by analyzing them in the context of a family; using this analysis to address issues and assess various parts of “sub-personalities” of a person
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Parent-Child Interaction Therapy [PCIT]: teaching parents how to improve their relationships with their children by better interacting with them, often with the goal of reducing negative behaviors and strengthening bonds
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Parent Work: helping parents improve their parenting by analyzing the relationship between parent and child, exploring themes and developing a positive parenting narrative
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Satir Transformational Systemic Therapy: improving relationships and communication within a family by addressing actions, emotions and perceptions in the context of a family dynamic
Group Therapy
In group therapy there are types of groups and therapeutic approaches for groups. Although most of them deal with some form of substance abuse, the issues can range from trauma and grief to abuse and addiction.
Here are the most common types and approaches:
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Cognitive-Behavioral/Problem Solving Groups: using the CBT approach to interpret addiction and dependency as learned behaviors clients can modify
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Interpersonal Process Group Psychotherapy: healing by changing maladaptive internal and interpersonal psychological dynamics
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Modified Dynamic Group Therapy [MDGT]: using an interpersonal approach to address the self-regulatory ego deficits of abusers and addicts
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Psychoeducational Groups: educating clients about substance abuse, related behaviors and consequences
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Skills Development Groups: teaching people the skills they need to abstain from abusing drugs
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Support Groups: strengthening interpersonal skills and working with other clients to maintain abstinence and improve self-esteem, confidence, etc.
Short-Term or Long-Term Therapy Options
When clients begin therapy, they can request short-term therapy and work with the therapist to set a timeframe. They can also seek a therapist who practices a form of brief therapy. If the therapist practices a form of brief therapy, he or she will suggest or prescribe a timeframe.
The duration of mental health treatment depends on the therapeutic approach, the severity of issues and both the client and therapist’s preferences. 12 weeks is the typical time it takes to see results and 10-20 weeks is the typical range for brief therapy. Therapy can be shorter or much longer than that, though.
Some clients — regardless of choosing short or long-term psychotherapy — leave therapy when they have dealt with the most acute symptoms of their condition or resolved the issue they sought treatment for. Others stay because they see therapy as a long-term journey to improve their mental health and become a better version of themselves. These people work with therapists for years, sometimes decades.
Most therapeutic approaches can be short or long-term depending on the client’s preferences, but there are a few that are only short-term. Here is a quick list of them:
Types of Psychotherapies That Are Only Short-Term
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Coherence Therapy (Depth-Oriented Brief Therapy)
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Intensive Short-Term Dynamic Therapy
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Interpersonal Psychotherapy
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Solution-Focused Brief Therapy
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Trauma-Focused Cognitive Behavioral Therapy
Long-Term Therapy
Most therapeutic approaches, especially when applied as an eclectic intervention can be long term. A client may decide to extend therapy, due to evolving goals or for mental health maintenance.
Therapy for People of a Certain Sexual Orientation, Race, Income Level, Gender, Religion, Political Ideology and More
To address the needs of minorities and people who want therapy that focuses on a specific part of their identity, therapists created psychotherapies for clients of certain groups. Here are some examples:
Affirmative Psychotherapy (for LGBTQIA+ community members)
Because of a history of mental health professionals pathologizing non-heterosexual orientations and trying to change them, psychotherapists created affirmative psychotherapy that focuses on authenticity and accepting sexual orientation.
Gender Aware Therapy (GAT)
GAT encourages male and female clients to explore gender-related experiences. It incorporates feminist therapy and is a great option for men and women who feel they need to address issues related to their gender.
Feminist Therapy
Feminist therapy acknowledges that women may experience mental health issues as a result of psychological oppression that targets them because of their gender.
Multicultural Counseling
Multicultural counseling incorporates an understanding, sensitivity and appreciation of the history, values and experiences of minority groups. It recognizes differences between the counselor and client.
Religious Therapy
There are therapists who specialize in working with clients of all religious backgrounds. Nonetheless, not all religious therapies have standardized names. Here are a few that have commonly-used terms to describe them:
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Biblical Counseling, Christian Counseling, Pastoral Counseling, etc. (forms of therapy that combine psychotherapeutic practices and Christian philosophy)
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Quranic Psychotherapy (therapy for Muslims or therapy that incorporates the teaching of the Quran)
Therapy for Certain Life Events, Medical Issues and Situations (Childbirth, Divorce, Death, Impotence, Infertility, etc.)
Sometimes therapy is simply a way to cope with a rough period of life or a medical issue with mental health consequences or roots. Here are some types of therapy that address these issues (remember that many therapeutic approaches can address these issues):
- Addiction Counseling (helping clients beat their addictions and address the related psychological factors; the addiction can be for anything, including drugs, sex, pornography etc.)
- Divorce Counseling (for couples who want to maintain good relationships and mental health despite going through a divorce)
- Erectile Dysfunction Sex Therapy (addressing the mental issues that might be contributing to erectile dysfunction)
- Grief Counseling (coping with the death of a loved one)
- Postpartum Counseling (coping with life changes and emotional adjustment after having a child or postpartum depression)
- Sex Therapy (treating sexual dysfunction when there is no medical reason for the dysfunction)
- Therapy for Infertility (coping with the emotional pain of being unable to conceive a child or maintain successful pregnancy to term.)
- Therapy for Infidelity (coping with the aftermath of an affair and deciding whether to end or heal the relationship)
- Therapy for Miscarriages (coping with the emotional pain and trauma of a miscarriage)
- Therapy for Pregnancy (coping with body and life changes during pregnancy)
Therapy for Certain Mental Health Issues and Illnesses
The vast majority of therapeutic approaches do not apply to only one mental health issue or illness. Psychotherapists can use an approach to treat depression, for example, but there is no “Depression Therapy.” Nonetheless, some types of psychotherapy are especially effective for certain issues and illnesses.
Below is a short list of therapeutic approaches and types that are especially effective for treating certain mental health conditions (listed in the parentheticals):
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Behavioral Types of Therapy (
Attention Deficit Hyperactivity Disorder
[ADHD])
-
Dialectical Behavior Therapy (borderline personality disorder [BPD], eating disorders, PTSD, self-harming or suicidal behavior)
-
Exposure Response Prevention Therapy (obsessive compulsive disorder [OCD])
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Group Therapy (Addiction)
-
Schema Therapy (borderline personality disorder)
Most types of therapy can address the following issues and illnesses:
Which Therapy Combination is Best for You?
If you are an aspiring therapist or a potential client seeking a type of psychotherapy, use the factors in this guide to decide exactly what you want. Think about which factor you value most. Is it the therapeutic approach? Is it the issues you might tackle?
Here are some examples of combinations you could consider:
- Long-term online therapy that uses an integrated approach and focuses on depression
- Short-term couples therapy that uses the Gottman Method
- Multicultural counseling that sometimes uses an existential approach
Once you figure out which type is best for you, it will be easier to structure your career or find a therapist who can help you rapidly improve your mental health and be happier.
Note: By using Talkspace’s matching system or chatting with our matching specialists, you can quickly and easily find a therapist who specializes in many of the types of therapy in this guide.
Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.
Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.
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